Thrombomodulin and Syndecan-1 and Association With Lung Function in Liver Transplant Recipients

13 Apr 20264 min read0 viewsJournal Feed

GIST

IntroductionLiver transplant recipients have an increased risk of pulmonary complications, yet the pathogenesis remains poorly elucidated. The pulmonary endothelium is central in maintaining lung function, and endothelial dysfunction may contribute to airflow obstruction.

Soluble thrombomodulin (TM) and syndecan-1 (SDC-1) are markers of endothelial damage, but whether TM and SDC-1 are related to lung function in liver transplant recipients remain unknown. This study investigated whether TM and SDC-1 are associated with forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and airflow obstruction in liver transplant recipients.MethodsWe included liver transplant recipients from The Danish Comorbidity in Liver Transplant Recipients (DACOLT) study.

Airflow obstruction was defined as FEV1/FVC <0.7. TM and SDC-1 were dichotomized, and an elevated concentration was defined as above the 3rd quartile.

Outcomes were analyzed using linear and logistic regression.Results340 liver transplant recipients were included. Liver transplant recipients with elevated TM had 39.5 mL lower FEV1 than liver transplant recipients with low TM (95% CI: -173.7;94.7, p=0.564), and 72.2 mL lower FVC (95% CI: -227.2;82.8, p=0.362), adjusted for confounders.

Clinical Editorial

Study context and design

Associations with continuous lung function measures were assessed by linear regression, and with airflow obstruction by logistic regression, adjusting for confounders.

Population: Liver transplant recipients drawn from the Danish DACOLT cohort.
Objective: To determine whether soluble thrombomodulin (TM) and syndecan-1 (SDC-1), markers of endothelial damage, relate to lung function measures.
Outcomes and definitions: Lung function outcomes included forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and airflow obstruction defined by a FEV1/FVC ratio below 0.7.
Analytical approach: TM and SDC-1 were categorized into elevated versus non-elevated groups using the upper quartile as the threshold.

Key findings on TM and lung function

Elevated TM associations: Compared with lower TM, elevated TM corresponded to modestly lower FEV1 by 39.5 mL (95% CI: -173.7 to 94.7; p = 0.564) and lower FVC by 72.2 mL (95% CI: -227.2 to 82.8; p = 0.362) after adjustment.
Airflow obstruction: The odds of airflow obstruction for elevated TM were not increased (OR 1.01; 95% CI: 0.43 to 2.38; p = 0.984).

Key findings on SDC-1 and lung function

Elevated SDC-1 associations: Elevated SDC-1 was linked to lower FEV1 by 93.4 mL (95% CI: -223.1 to 36.3; p = 0.159) and lower FVC by 31.2 mL (95% CI: -181.6 to 119.2; p = 0.684) relative to non-elevated SDC-1, after adjustment.
Airflow obstruction: The odds of obstruction for elevated SDC-1 did not differ significantly (OR 0.97; 95% CI: 0.42 to 2.27; p = 0.950).

Interpretation and limitations

Conclusion: The study did not detect statistically significant associations between TM or SDC-1 levels and FEV1, FVC, or airflow obstruction in this liver transplant cohort.
Uncertainty and limitations: Confidence intervals encompass a range that includes no effect, and analyses are observational with potential residual confounding.